Electronic 270° transverse-array endoscopic ultrasound scan (EUS) provides high-quality cross-sectional images but cannot guide fine needle aspiration.
Linear endoscopic ultrasound scan provides longitudinal images of malignancies and the ability to guide fine needle aspiration.
Dr William Brugge and colleagues from Massachusetts assessed electronic transverse-array vs linear endoscopic ultrasound scan for the staging of upper-gastrointestinal (GI) malignancies.
The research team conducted a prospective randomized comparison of 43 patients.
|About 3 nodes per patient were detected using transverse-array EUS|
Of these patients, 27 underwent linear endoscopic ultrasound scan immediately followed by transverse-array endoscopic ultrasound scan.
The remaining 16 patients received transverse-array endoscopic ultrasound scan immediately followed by linear endoscopic ultrasound scan.
The mean age of the patients was 64 years; and 37 were men.
The team noted that 4 had a stomach malignancy, and 38 presented with esophageal malignancies.
The patients were evaluated with both transverse-array and linear endoscopic ultrasound scan.
Abnormal lymph nodes were sampled by fine needle aspiration for cytology.
The researchers found agreement on the T stage by linear and radial techniques in 88%.
The team observed that 63% had abnormal lymph nodes by linear or transverse-array imaging.
Linear endoscopic ultrasound scan demonstrated 66 abnormal lymph nodes in 27 patients, an average of 2 nodes per patient.
The researchers demonstrated 90 abnormal lymph nodes in 27 patients, an average of 3 nodes per patient using transverse-array endoscopic ultrasound scan.
In 16 of the 27 subjects, an fine needle aspiration was performed, which was positive in 81%, and negative in 10% for malignancy.
Dr Brugge's team concludes, “Transverse-array and linear endoscopic ultrasound scan provide similar results of T staging of upper GI malignancies.”
“However, the number of abnormal lymph nodes detected by transverse-array endoscopic ultrasound scan was more than by linear endoscopic ultrasound scan.”
“These findings suggest that radial or transverse-array endoscopic ultrasound scan imaging should be the primary method for staging of upper GI malignancies.”